Dorsal and Alar Support with Rib Graft and Scalp Fascia - Los Angeles, CA

I have a preforated septum with a hole too large...

I have a preforated septum with a hole too large to repair. I noticed that my nose felt a lot softer, my nostrils collapsed when I inhaled and I had a slight saddleback deformity. My plastic surgeon was also a otolaryngologist and described the procedures to me clearly. My biggest concern was that my nose would look different - I like my small nose and couldn't imagine adding grafts without significant bulk. I'm 12 days after surgery and even swollen my nose looks normal. The surgery took 5.5 hours and I ended up with rib grafts supporting my nostrils and the top of my nose with some scalp fascia on top to pad the graft. We had talked about maybe some ear going somewhere in the mix, but he didn't need it. So I had stitches under my breast, staples in my scalp and a cast on my swollen nose. Yikes. The admitting nurse told me that it was important to take my pain meds before I needed them so my body could not be stressed by pain and focus on healing. Great advice! I usually try to be tough about pain, but kept this under control and wasn't that uncomfortable. I got splints out of my nose and cast removed after a week. This is the bad news. Removal of the stitches at my nostrils that held the splints HURT. I called the Dr. a horrible name. It is still sensitive. And the incision under my breast hurts, but nothing Tylenol can't handle. I'm glad I did this before saddleback got worse. I was scared, but it went well and my doctor was fabulous. He wasn't going to get creative and give me a new nose and he handled my nervousness with calm confidence.

Everyday is better - finally.

Rib Incision: I thought pain and general malaise were normal, but after 3 or 4 days of feeling no improvement and increasing pain - reaching to turn water on made me yelp - I called my dr. The incision was slightly infected and just 3 days of antibiotics has made a world of difference! Things still ache and itch, but less each day and I don't have to hold my arm to my body anymore - woo hop!
Scalp: The worst right now. It hurts and pulls in my temple when I open my mouth. The initial scab has mostly flaked off, but the red area is tender, raised and lumpy and for about 2 inches around it feels bruised.
Nose: Though I know it's still a little swollen, particularly on one side, I have to point it out to anyone else. My pores are horribly clogged, but it's still a "no touch", so I wash it gently, apply masque and "rinse" with a soft paintbrush. Rinsing takes forever, but I bumped it slightly bringing water up, so paintbrush it is. I still keep my glasses tied up off my nose. It is tender to touch and sometimes when my face is animated I can feel it move, but I can't help that. It runs a lot and the mucus stretches like thin rubber cement, so I go through a lot of tissue gently dabbing wishing I could blow for Pete's sake! I've trained myself to use saline when it itches or feels tight or I feel like touching. I'm wondering if I can be addicted to saline rinse. It's really bothering me that my nostrils are asymmetrical and a completely different shape than my real ones. I keep telling myself that 18 days isn't enough time to judge, but asymmetry is not something I will settle for if it doesn't resolve itself. At this point it's easy to forget that I had this done - the routines and rules are my new normal. I have to remind myself that I'm still healing, to slow down, get some rest and say no to climbing Mt. Everest.

"Better" is relative and it's not all pretty.

I think I'm 7 weeks post. And my nose is still sensitive. Yesterday was the first day I could use pressure on a washcloth without feeling like things were shifting around. And I can gently plug my nose - useful when it's pouring clear, ridiculous mucus since blowing is out of the question. Last week I still had a couple out of the blue bolts of pain in my nose. They don't last long, but darn if I didn't yelp and one made me cry. Two weeks ago I had one a day so...
My scalp got really, really irritated when I went back to school 2 weeks ago - probably because I was brushing my hair. :) I tried to introduce painkilling Neosporin as a new hair gel. It didn't work so I had goopy hair. It itches once in awhile and is ugly!!!!, but what can I do?
Rib scar is looking good, but for as good as it looks it can still be sensitive. Today was hot and humid and after PE class, it hurt for 2 - 3 hours. I was surprised!
Because I had so little cartilage in my nose, it was pretty flimsy and "light", so it's very strange to have a hard nose. It feels heavy and doesn't seem like it's part of me, as if someone put a hard blob where my nose used to be. It's very strange.
Of course it looks 90% the same and I am the only one who sees the 10%. But I do! My nostrils are skinny and one is more skinny, and getting skinnier, than the other. When I move my nose when I talk, the skin between my nostrils turns white. Someone else actually noticed this!! Aaah!
I keep telling myself "still healing, still healing".
Right under the skin (septum?) between my nostrils there is a hard bony extension (projection?) towards my lips. Can anyone else see it? No. It hurt when I touched so I don't touch. but my nose ended at my nostrils before and it's bugging me that part of it, albeit tiny, goes beyond.
Here's the bad part. When I smile I get an obvious crease between my upper lip and my nose. It mirrors my smile and erases my upper lip - which was thin to begin with. I've tried tiny smiles - still there. I've tried barely turning the corners of my mouth up - not easy, my smile muscles shake, but the crease is still there. I've stopped smiling in photos. In my birthday party pictures I look like a mug shot. I can't help spontaneous smiles, but I'm self conscious about smiling at cute strangers. First my mouth is shaking because I'm trying to barely smile and second I have a crease like Jack Nicholson as The Joker's smile above my mouth. Maybe that's an exaggeration, but it's how I feel. I know my doctor will see me, but what will I do if he tells me that the crease will be there for the rest of my life?
I'm going to keep reminding myself "still healing, still healing" and hope it's just a bump/crease in the road.

Hair loss no myth

About 5 months ago I had an off the menu rhinoplasty - I had my rib cartilage removed and put in my nose and pieces of my scalp put on top of that. (See review)I think the surgery was 5.5 - 6 hours. I asked my doctor about hair loss from surgery and he poo-pooed the idea. HA! 3 months to the bloody date I began losing handfuls of hair! Handfuls! Of course when I mentioned this at my 3 month checkup, he said " If your losing your hair it's not from anything I did. If anything it is from the anesthesia so you should talk to the anesthesiologist." Whatever - can't have one without the other, can you? If you're reading this you probably know the theory about one's body to slowing down nonessential functions to focus on the important stuff slowed down by anesthesia. And I think I may buy in. Aside from this ridiculous balding, my fingernails have a large dent at right around 3 months growth - hmmmm, fingernail growth is nonessential, right? Bottom line - if my hair doesn't come back, I will wish I had known before nose surgery. I would seriously think about which would be worse - deformed nose or no hair. At my 3 mo my doctor said he was performing almost same procedures the next day and would I tell the patient it was worth it. I asked gender and age - 55 yo, female. I answered NO! Unless she HAD to! Hair thinning related to menopause and then add 5+ hours of anesthesia?!? And then the stress of losing your hair?! I would break.
Los Angeles Plastic Surgeon

I cannot gush more. Ridiculously accredited, confident without conceit, calm demeanor in face of semi-hysterical patient (me), answered lists and 3 page emails of questions about everything from hair loss to nostril size in millimeters, a couple of forgivable issues with office staff, but quickly cleared up with appropriate explanations.

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
5 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
4 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
5 out of 5 stars Wait times
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